Syphilis, congenital

Reportable by Laboratories and Providers

About this Reportable Disease

Infectious agent: Treponema Pallidum

Description of illness: Congenital syphilis is a bacterial infection that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. Congenital syphilis is linked to low birth weight, miscarriage, and stillbirth. An infected baby may be born without any signs or symptoms and go on develop serious health problems within a few weeks. Congenital syphilis can be treated with an antibiotic, but the damage that has been done is irreversible. Untreated babies may die or develop serious health problems such as cataracts, deafness, and seizures. Congenital syphilis can be prevented if a mother is treated early enough during pregnancy. All pregnant women should be screened for syphilis at the first prenatal visit; women at risk should also be screened at the beginning of the third trimester and again at the time of delivery.

Interactive Disease Data

Laboratory Reporting for this Disease

Syphilis Screen by RPR

TEST NAME	Syphilis Screen by RPR
DISEASE DISORDER	Syphilis
ALTERNATE NAME(S)	Treponema pallidum, RPR
METHODOLOGY	Arlington Scientific, Inc (ASI) Rapid Plasma Reagin (RPR) Card Test For Syphilis (nontreponemal flocculation test, qualitative/semi-quantitative)
SPECIAL INSTRUCTIONS	This test is not approved for testing spinal fluids.
ORDERING INFORMATION	Lab Web Portal PTBMIS: Test Order Code: 86592 Test Order Description: Syphilis Test

Specimen Requirements

Patient Preparation	Venipuncture
Specimen Collection	Acceptable specimen types: - Whole blood in Red Top Serum Coagulation Tube or Serum Separator Tube (SST) - Serum in sterile, plastic, screw-capped vial
Specimen Labeling	Specimen should be labled with at least two unique patient identifiers and match accompanying test order.
Specimen Processing	Follow the tube manufacture's processing instructions for collection tubes.
Specimen Storage and Preservation	Specimens may be stored at 2 - 30°C for up to 72 hours post collection. Specimens may be stored at 2 - 8°C for up to seven (7) days. If testing will be delayed more than seven (7) days, aliquot serum into a sterile, plastic, screw-capped vial and store at -20°C or colder.
Specimen Transportation	Ship specimens at 2 - 8°C on cold packs, if possible. Specimens may be shipped at 2-30°C if receipt at laboratory will occur within 72 hours of collection. Specimens should be be placed in a biohazard bag with absorbent material. All infectious substance shipments must conform to U.S. Department of Transportation (DOT) Hazardous Materials Regulations (HMR 49 C.F.R. Parts 171-180).
Specimen Acceptability and Rejection	Grossly hemolyzed, lipemic, or microbially contaminated specimens will be rejected. If expiration date on collection tube is prior to collection date, specimen will be rejected. Specimens received after expiration of viability will be rejected. Unlabeled or improperly identified specimens will be rejected. Specimens collected in unapproved tube types will be rejected. Specimens broken in transit will be rejected. Specimens leaking in transit may be rejected after assessment of viability and contamination. Specimens with insufficient volumes of serum will be rejected. Specimens with clerical errors in the lab order or on the specimen tube will be rejected. Specimens transported or stored at incorrect temperatures will be rejected.
Testing Location	Nashville Knoxville

Laboratory Reporting

Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.

Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.

Information about this Reportable Disease for Healthcare Providers

Clinical Summary

Congenital syphilis occurs when a pregnant person with syphilis transmits the Treponema pallidum bacterium to their baby during pregnancy.
The infection can result in miscarriage, stillbirth, premature birth, or severe illness in the newborn.
Symptoms in infants may include jaundice, enlarged liver or spleen, skin rashes, anemia, and neurological problems.
Some infants show no symptoms at birth, but an untreated infection can cause complications later in life.
Early detection through prenatal screening and treatment with penicillin is critical to prevent severe outcomes.

Clinical Links & Info

Review the case definition | CDC

Access the case report form (2010) | TDH

Collecting laboratory samples | CDC

Congenital Syphilis Prevention Page | TDH

Healthcare Provider Reporting

Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.

Providers must report cases of all diseases and conditions listed through one of these methods:

• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857

• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.

• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.

• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.

Information about this Reportable Disease for the Public

What It Is

Congenital syphilis (CS) occurs when Treponema pallidum, the bacterium causing syphilis, is transmitted from a pregnant person to their baby during pregnancy. Without treatment, CS can lead to severe health issues or death in newborns. Cases of CS have more than tripled in recent years, with nearly 4,000 cases reported in 2024 alone, marking the highest number since 1994.

Types

CS manifests in two stages:

Early congenital syphilis: Symptoms appear at birth or within the first few weeks.

Late congenital syphilis: Symptoms develop after the first two years of life, potentially leading to long-term complications.

Signs and Symptoms

CS can cause:

Miscarriage or stillbirth
Prematurity and low birth weight
Enlarged liver and spleen
Jaundice (yellowing of the skin or eyes)
Skin rashes
Brain and nerve problems, such as blindness or deafness
Meningitis
Severe anemia

Not all infants show symptoms at birth; some develop issues later without treatment.

Treatment

Treatment involves administering antibiotics to the newborn:

Aqueous crystalline penicillin G: 100,000–150,000 units/kg/day IV for 10 days.

Procaine penicillin G: 50,000 units/kg/day IM for 10 days.

Benzathine penicillin G: 50,000 units/kg IM as a single dose, if certain criteria are met.

This Page Last Updated: March 25, 2026 at 8:56 PM